Spinal Cord Stimulation
A spinal cord stimulator is a device used to direct pulsed electrical signals to the spinal cord to help to reduce chronic pain. Further applications are in Dorsal Root Ganglion (DRG) stimulation. Spinal cord stimulation (SCS), in the simplest form, consists of stimulating electrodes, implanted in the epidural space, an electrical pulse generator, implanted in the upper gluteal or buttock region. SCS has notable analgesic properties and, at the present, is used mostly in the treatment of failed back surgery syndrome, complex regional pain syndrome and chronic pain of the trunk and limbs.
Successful outcomes are ensured by observing and adhering to careful patient selection criteria. Patient’s typically do best when their pain is neuropathic and non-migratory, when there is limited chemical dependence and when there is minimal psychological overlay associated with their pain. Patients are screened over several days with test leads to determine if proper paresthesia coverage and pain relief are achievable. The parameters of electrical stimulation are externally set by a programmer and are tailored to the needs of the individual patient.
Spinal Cord Stimulation trial and implantation instructions
Pre-op Instructions:
- Nothing to eat or drink after midnight the day of the procedure
- Please make sure your driver is always with you.
- Please notify the physician if you are on blood thinning medications, as
these medications may need to be held prior to your procedure, during and after.
Post-op Instructions:
- No showering or tub bathing throughout the duration of your trial - sponge bathing is ok; however, you must keep the area on your back with bandages clean and dry so as to prevent and avoid infection and lead migration.
- No bending, lifting, or twisting – the leads are in your body and any excessive, rapid, or sudden movement can lead to displacement and cause your stimulation pattern to change. If you are undergoing a trial lead placement, this may disrupt the quality of your trial and result in an unfortunate and premature termination.
- You will experience postural/positional changes of the stimulation - this is normal
- Any questions regarding the equipment must be directed toward your assigned representative - concerns regarding your stimulation changes/questions, or potential reprogramming matters should be directed to your representative. You will be provided with their contact number.
- Any medical concerns should be directed to your physician office – any wound issues or medication issues should be directed toward your managing physician.
- You should expect follow up calls from your representative to check on the status of your trial stimulator - you are expected to be readily available during the week of your trial and to return calls from the representative. Please respond to the representative within 24 hours, as time is essential to the success of the treatment. You may be required to meet with the representative at your physician’s office, in order to modify the stimulation during the trial.
- Your trial leads will be removed in the IPRMS physician office.
- Permanent implants will typically be performed in an ambulatory surgery center (ASC). You will have two post-op visits: The first visit will be at approximately 7 - 14 days and is geared toward examining the healing process as well as additional education and programming. The second visit occurs at approximately six weeks post-op for activation of adaptive stimulation.
- Additional visits may be necessary for teaching and reprogramming.
